{
  "abstract": "Non-invasive ventilation (NIV) has proven clinical benefits in treating acute type 2 respiratory failure (T2RF), but can contribute to distress in the acute setting (Demoule et al., 2018). This anxiety can result in poor NIV compliance - impacting on clinical outcomes such as length of stay, mortality, and morbidity (Yıldız et al., 2022).This study sought to identify the contributory factors to distress when acute NIV is initiated, thus illuminating key actions to alleviate anxiety and promote patient compliance.All patients who received acute NIV for T2RF within a three-month period were approached with written information to obtain study consent. A semi-structured standardised telephone interview was conducted two weeks post-discharge with participants to minimise recall bias. Interviews were audio recorded, transcribed, and analysed by trained members of the study team. Patients were given the option to opt out at any time.42 patients were identified as eligible to participate. Amongst these, the study recruited 19 patients from 1 December 2024 to 1 March 2025. 4 patients consented were lost to follow up with 1 patient withdrawing initial consent. 8 patients declined to participate. A number of patients were deemed inappropriate due to frailty (n=4), being end of life (n=8) and lacking capacity (n=3). BTS NIV Audit was conducted parallel to assess confounding factors.Qualitative thematic analysis identified aspects of patient care pivotal to compliance and patient anxiety. Key themes included difficulties with mask fitting and claustrophobia, interrupted sleep for monitoring, and communication from clinical staff to reassure and convey important clinical information on progress (see figure 1).Abstract P224 Figure 1A targeted action plan to focus on mask fitting, seal, comfort and adjustment, and communication was implemented. Healthcare staff involved in NIV provision attended advanced communication and interdisciplinary simulation training. Twice daily prompts were included in the NIV care plan to support communication on weaning and clinical progress. Open dialogue from clinical staff to assess comfort and sleep quality and pressure sore areas were standardised. A variety of masks with adjustable straps and interfaces were introduced.A repeat analysis of patient satisfaction and anxiety/distress levels is planned to be conducted in the autumn.",
  "authors": [
    {
      "affiliations": [
        "Wye Valley NHS Trust, Hereford, UK"
      ],
      "name": "P Quinn"
    },
    {
      "affiliations": [
        "Wye Valley NHS Trust, Hereford, UK"
      ],
      "name": "R Hall"
    },
    {
      "affiliations": [
        "Wye Valley NHS Trust, Hereford, UK"
      ],
      "name": "K Ling"
    },
    {
      "affiliations": [
        "Wye Valley NHS Trust, Hereford, UK"
      ],
      "name": "I Du Rand"
    }
  ],
  "title": "P224 ‘NIV? Not for me.’ – a pilot retrospective ‘service improvement’ qualitative study examining the psychological impact of hospital-based non-invasive ventilation (NIV) when treating acute type 2 respiratory failure",
  "uid": "2f7a0619-b560-5f0a-8306-57434e53184e"
}